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Growing pains: Ellie Mae-Holden had treatment to prevent the early onset of puberty

At the age of three, the worries of most little girls rarely stretch beyond what outfit to dress their dolls in, and how to ride a bike.

But for Hayley Smith, her third year brought a set of problems most children her age wouldn't even have heard of, let alone been able to comprehend - puberty.
While her baby-sized friends enjoyed the simplest of life's pleasures, Hayley spent her time laid up on the sofa with period pains.
She also had to put up with other un-pleasantries of puberty, including body odour, greasy hair and mood swings. Not surprisingly, her parents, Debbie, 41, a chemist and David, 45, a project manager from Nottingham, were left both distraught and baffled by the changes in their daughter's body, and behaviour

I first noticed Hayley had body odour shortly after she'd turned three," says Debbie, who also has a 12-year-old son, Carl.

"Around the same time, she suddenly gained a lot of weight, despite not eating any more than she usually did. I thought it was very odd, and I mentioned it to my mother.
"When she told me that you wouldn't expect body odour until a child was approaching their teens, I felt sick with worry. I knew something wasn't right. Then, a few months later, I noticed pubic hair growth, and her breasts were beginning to grow too.
"Hayley was still going to nursery, and didn't seem unwell. All she wanted to do was make cakes and do colouring in. But David and I were very upset, and worried sick.
"Until then, Hayley had been a textbook child, hitting every developmental milestone at exactly the right time. We couldn't work out what was happening to her."
A series of tests with an endocrinologist - a doctor specialising in hormone-related disorders - revealed that Hayley's bone age was advanced, but no firm diagnosis was reached.
Instead, her parents say they were made to feel as though they were over-reacting. However, by the time Hayley was approaching her fourth birthday, it was clear to Debbie that she was on the verge of menstruating.
"Hayley started suffering from terrible stomach cramps and mood swings," says Debbie, who in a bid to raise awareness of the condition is appearing on ITV's Tonight programme this evening.
"She'd lie on the sofa, and tell me she felt tired and miserable. I kept a record of when she was unwell in my diary, and I quickly realised that her symptoms were coming in a regular monthly cycle.
"The thought that my three-year-old girl was getting her period seemed incomprehensible, but at the same time, it was becoming obvious to me that her mood swings and stomach cramps were to do with her time of the month.
"The endocrinologist may have dismissed my worries, but I could just tell that my daughter was entering puberty."
And Debbie's instincts proved to be correct. After numerous examinations and tests over the following 18 months, Hayley, at age six, was finally diagnosed with precocious puberty, a condition in which puberty begins at an unusually early age often due to abnormal production of oestrogen, thought to affect as many as one in six children under ten.
Although her periods didn't start until she was eight, her monthly cycle of stomach cramps and bad moods had been a warning sign that her ovaries were maturing, and were a sign of the fluctuating hormones that define puberty.
Her breasts also grew and Hayley, now aged 12, wears a C cup bra.
"Hayley has always taken it all in her stride," says Debbie. "I thought for instance that she'd be upset when at five she had to start using deodorant. But she didn't say to anything to me about being different to other children, and she didn't seem to be confused either.

"Instead, she told me she 'liked being like Mummy'. I bought her a book called My Changing Body, which I used to read to her at night time to help her understand what was happening to her, and she didn't seem frightened or scared by any of it.
"I meanwhile, was extremely confused as to how it was possible that a child who was only just forming sentences and learning to read and write was developing the body of a growing adult.

"And it did get to her when she was the only girl sitting on the side of the pool in swimming lessons because of her periods. She felt very left out. As a result of the hormone imbalances in her body, the condition has made her overweight and unusually tall for her age, which has meant she has endured some bullying too.
"Things are getting better now that the other girls are catching up with her, but Hayley still struggles to control her weight.
"And I still have sleepless nights about it. Although I've been reassured the condition won't affect her future fertility, I find it hard to see how it could have no impact at all."
And Hayley is far from alone. Over the past century, the normal age at which puberty starts in both boys and girls has dropped by about two years.
In fact, a recent study showed that British girls today start their periods at an average age of ten years and three months, compared to 11 years nine months for their mothers and 12 years for their grandmothers.
But for a small group of children - there are no official figures - puberty is coming even earlier.

The condition is more common in girls, but in young boys, precocious puberty causes rapid growth spurts, acne, the growth of facial and pubic hair and a deepening of the voice.
"In most cases, puberty would be considered precocious if it started in a girl aged eight to ten and a little later for boys," says Tam Fry, spokesperson for the Child Growth Foundation. "But some of the children we have been dealing with have been displaying signs of puberty as early as three years old.
"It is a tremendously concerning condition - both for the parents and for the children in question.
"There are a number of girls who have been left seriously traumatised by going through puberty at a stage where, mentally, they are not equipped to cope with it. And it's very hard to cope in daily life if you're an eight-year-old girl who looks like a mature woman."
Certainly, that was the experience of Lucia Reed, now 20, who started having periods at the age of six. A graphic design student from West London, Lucia has haunting memories of receiving sexual attention from grown men at a very young age.
"The hardest thing of all about precocious puberty was that men would come on to me as though I was an adult. "I remember walking home from school aged eight, and I'd often get followed by men leering at my body. I was still in primary school and had no idea what was happening. I used to have to phone my mother and get her to come and pick me up. It was really frightening."
Though she is now able to speak candidly about going through puberty so early, it is clear that even if a child puts on a brave face, life can be very difficult. Lucia says precocious puberty left her isolated from her peers, and lead to frequent medical examinations which terrified her.

"I don't remember being told I had precocious puberty as such, or even the day my periods started," says Lucia. "All I remember is feeling completely alone and alienated as a child. I was overweight, much taller than everyone else - at one point I grew an inch a month - and I stood out like a sore thumb. At the age of seven, I had the bone age of a 14-year-old and was almost five foot tall.
"But it wasn't just my height. My breasts developed too - I had to wear a bra from the age of eight, and the other children teased me relentlessly. I also had to cope with terrible acne, greasy hair and huge mood swings.
"I ended up feeling very self-conscious and really uncomfortable in my body. I suffered from terrible growing pains too, and I was far too embarrassed to tell my peers about my periods, which left me feeling as though I was carrying a horrible secret around with me."

Even at secondary school - by which point her peers had started to catch up - Lucia still felt like an outsider.
"I was still larger than the other girls, so I ended up taking on the role of mother hen," she says. "My peers were beginning to come to me for advice, which helped me feel a bit better about myself.
"But even so, I still knew I was different, and I just wanted to be like everyone else. I think of childhood and my teens as very lonely times indeed."
While some parents - such as Debbie, and Lucia's parents - chose to let nature take its course and allow puberty to continue, others opt to give their child treatment, which involves suppressing the secretions of hormones which initiate puberty with a range of drugs and injections.
With treatment, actual puberty can be staved off until the child reaches a more appropriate age.
That was the decision taken by Hayley Holden, 31, a full-time mum from Padstow, Cornwall, when she discovered her daughter Ellie Mae, then just three, was on the verge of starting her periods.
Hayley had taken Ellie Mae to the doctor, concerned she was developing breasts. Her GP spotted the signs of precocious puberty immediately.
"I'd never even heard of precocious puberty, and although I was concerned enough about Ellie Mae to take her to a doctor, I actually thought I was imagining things," says Hayley, who is separated from Ellie Mae's father and has three other children, twins Charlie and Chloe, 11, and Albie, 4.
"But a bone density test revealed that at just three, Ellie Mae had the bone age of a nine-year-old, and I was told that if we didn't intervene with medication, she was just six months away from starting her periods. I was in bits when we got the news. I just had no idea what to think about it."
"I felt that full-blown puberty at the age of four would be too much for Ellie Mae to cope with,' says Hayley.

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"I know how hard it is to go through puberty, and I didn't want that for my daughter at such a young age. I guess I wanted to protect her from puberty for as long as possible."

As a result of treatment, Ellie Mae's breasts have reduced in size, and her bone age is now just a year older than her natural age. While this gives Ellie Mae a chance of a normal childhood, her mother is still troubled by what happened.
"The hardest thing is that we've never been given a reason as to why this happened, and I still to this day struggle to understand how a little girl of three could be on the verge of starting her periods,' says Hayley.
"Other people say to me I should feel grateful that she's not terminally ill - and of course I do - but at the same time I worry about her future.
"Ellie Mae still gets terrible monthly mood swings as well, which is very difficult for everyone else in the house. I also worry about whether or not she'll be able to have children, and whether she'll be at increased risk of osteoporosis as her bones have matured so early. Unfortunately, no one can give us any definitive answers."
So what is the cause of precocious puberty? While experts aren't able to give a single explanation, numerous theories exist.
One is that improved nutrition is a factor, as the onset of puberty is believed to be linked to physical size.
Another theory is that the epidemic of childhood obesity is to blame: heavier girls begin their periods earlier due to an increase of the puberty-triggering hormone leptin, which is stored in fat cells.
"There is a relationship between childhood nutrition and the age that people pass through puberty,' says Mark Bellis, Professor of Public Health at Liverpool's John Moores University.
"Having a calorie-rich diet in childhood, and being obese, brings the age of puberty down."
Modern social conditions have also been touted as a contributory factor - with research suggesting that children from broken homes experience earlier puberty as the stress of a family breakdown alters the balance of growth hormones.

The arrival of a stepfather in the family home produces new and unfamiliar pheromones, chemicals which are believed to hasten the arrival of puberty.
"Single-parent families and divorce cause stress that can also change the age of puberty a little, too," says Mark Bellis.
Early puberty has even been linked to watching too much television - Italian researchers found that children who watched three hours of TV a day produced less of the sleep hormone melatonin, low levels of which play an important role in the timing of puberty.
The content of today's television may also be to blame, with young children subjected to increasingly sexualised programmes from an early age. Research has shown that watching such images produces increased hormones.
Another theory is that exposure to chemicals in the environment - which mimic the effects of hormones - is causing the drop in puberty age and disrupting the normal timing of sexual maturation.
It is not known whether the condition has any serious longterm health implications, and early puberty has not, at this stage, been linked to early menopause.
However, there is evidence from American studies that children who develop early are more likely to be sexually active, smoke, and use alcohol and drugs. Sufferers are also more likely to become obese adults or suffer reproductive cancers.
Today, Lucia no longer stands out from her peers, but it is clear that she still carries the legacy of precocious puberty with her, and its potential fertility ramifications weigh heavily on her mind.
"I know I want to be a mother, and even though I've been told things should be fine, I can't help but feel concerned that I'll enter the menopause early, or find out I'm infertile," she says.
"I just have to hope that the doctors are right and I will be able to conceive. I try not to think about it too much, but the thought is always at the back of my mind. It's a worry I carry with me every day."

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That's horrible.
I can sort of relate, because my little cousin who is nine years old, started going through puberty at age 5. She developed pubic hair. Her breasts are developing, and her mother makes her wear a bra. She's a little tall, but she's always looked like a string bean! I have noticed that when she comes to give me hugs or sits on my lap that she has a little odor, and her mother buys her scented deodorant. The worst part about it is, her mother talks about it openly with strangers, right in front of her daughter. As if this experience isn't bad enough, she has to tell everyone about it!
To top it off, she makes her watch what she eats, and calls her fat and chubby on a daily basis. I reassure her that she is nothing but a normal stringy little girl that is FAR from being fat. I'm worried for her mental state, she seems fine, but her dad said he's noticed a lack of interest in things she used to love. I just hope that her doctors can figure something out.

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Good on her parents for making a fuss about this, though - i always read stories where parents are dismissed again and again by doctors with a bit of frustration. And as many as one in six kids are diagnosed with early puberty? That's heaps too common to be dismissed!

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That's absolutely horrible! I can't imagine having my period at the age of 3/4. At that age you shouldn't have to worry about all those puberty problems... horrible!
It's a very interesting article though!

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Monday , January 14, 2008
Girls usually don't have to worry about going through puberty until they are at least 10 to 13 years old  but, for one English girl, the process started much earlier, according to a report in the Daily Mail.
While her toddler friends enjoyed life's simplest pleasures, Hayley Smith spent her time dealing with menstrual pains.Click here to read Daily Mail story
She also had put up with other realities of puberty including body odor, greasy hair and mood swings.
Her parents, Debbie, 41, and David, 45, were both left baffled by the changes in their daughter's body, and behavior.
"I first noticed Hayley had body odor shortly after she'd turned three," said Debbie, who also has a 12-year-old son, Carl.
"Around the same time, she suddenly gained a lot of weight, despite not eating any more than she usually did. I thought it was very odd, and I mentioned it to my mother."
A series of tests with an endocrinologist revealed that Hayley's bone age was advanced, but no firm diagnosis was reached.
"The endocrinologist may have dismissed my worries, but I could just tell that my daughter was entering puberty."
Her instincts proved to be correct. After several examinations and tests over the following 18 months, Hayley was finally diagnosed with precocious puberty at the age of six. The condition, in which puberty begins at an unusually early age often due to abnormal production of estrogen, is thought to affect as many as one in six children under ten.